HUN 3403Fall 2012Review for final exam, included all the chapters and student presentations after our second exam. Adolescent, body composition, including fat mass, lean mass and skeletal mass, changes during puberty• Puberty: time frame during which the body matures from child to adulto Sexual Maturation Rating (SMR) for girls and boys = Tanner stages Stage 1 – pre pubertal growth Stages 2-5 occurrence of growth• Females – menarche – stage 4 Stage 5 – sexual maturationo Puberty correlates with changes in Weight• Approximately 10-15 lbs/yr body composition• Girls increase in fat mass• Boys decrease in fat mass Skeletal mass• By 18yrs. more than 90% of adult skeletal mass is formed• Dependent ono Geneticso weight bearing exerciseo smokingo alcoholo diet: calcium, phos. vit. D, proteino Large variation in rate of development Males: “late bloomers”- often feel inferior, more likely to turn to supplements for increased muscle and linear growth Females: Mature early and are more likely to adopt “grown-up behaviors” younger,o Females Average lean body mass falls from 80% to 74% of body weight Average body fat increases from 16% to 27% at full maturity 44% increase in lean body mass 120% in body fat during pubertyo Males Peak weight gain coincides with the timing of peak linear growth and peak muscle mass accumulation During peak weight gain, adolescent males gain an avg of 20 lb per yearEarly mature girls are more likely to…• Have an eating disorder• Have poorer body image• Initiate “grown up” behaviors younger, such as smoking, drinking, and sexual activityServings of vegetables consumption during adolescence• ~30% consume <1 serving of vegetables/dayThe influence factors of eating behaviors in adolescent• Factors: peer influences, parental modeling, food availability, food preferences, cost, convenience, personal and cultural beliefs, mass media and body image • Food behaviorso Meal skipping: breakfast is the most commonly skipped mealo Unhealthy dieting practices o Less meals with family More frequent family meals associated w/ dietary intake↑o High consumption of food in fat, & sugar↑ ~30% consume <1 serving of vegetables/day 57% (f) & 62% (m) consume <1serving of fruit /dayo More snacks: soft drinks are the most commonly chosen snacks for adolescent femaleso Fast food: less time with family and more time with peers at places such as fast food restaurants because they offer a social setting with cheap food They eat fast food 2x/wk. 16%/17% of energy intake among females/males –NHANES 2003-04Natural food sources of vitamin D• Natural/Animal sources: Found in fatty fish and milk• Alternate sources: fortified soy milk, fortified breakfast cerealsADULT NUTRITION:Stages of adulthood• Early Adulthood: 20’s and 30’s• Middle Adulthood: 40’s and 50’s• Older Adulthood: 60’s and upMenopause: definition and common symptoms, iron needs before and after menopause• Menopause: cessation of menses• The need for iron decreases from 18 to 8 mg daily• Loss of healthful benefits of estrogen leads too Atrophy of tissues in the urinary tract and vaginao Increased abdominal fato Greater risk for chronic conditions such as osteoporosis and heart diseaseo Bone loss-rate of 1-2%/ yr over next 10 yrs (osteoporosis)o Blood lipid levels - T Chol & LDL, HDL↑ ↓• Menopause is associated with, but not the cause of weight gain and decreases in muscle mass• Menopausal effects: hot flashes, fatigue, sleep disturbances, memory loss• Treatment options? HRT, teas, herbals, dietary supplements, creamso Black cohosh- hot flashes?o Phytoestrogens – hormone like substance found in plants Phytoestrogens can bind to estrogen receptors and mimic estrogen and anti-estrogen effects If estrogen levels are low, phytoestrogens can supplement endogenous estrogenDifferences among different types of vegetarian diets.Know how to calculate energy expenditures with equations• Determining energy needs: changes in body weight are due to a complex system of interactions including:o Gender/body size/muscle masso Activity levelso Health statuso Hormoneso Individual variation• Basal Metabolic Rate (BMR): measuring energy expenditure in an individual who has been awake less than 30 minutes and is still at absolute rest, fasted for 10 hours or more and is in a quiet room with normal comfortable temperatures.• Resting Metabolic Rate (RMR): measuring energy expenditure in an individual who has fasted, had no vigorous physical activity prior to the test, has been given time to relax for 30 minutes before starting measurement and is in a quiet room with comfortable temperatures.• Energy needs are based on:o BMR – basal metabolic rate* [BMR differs from RMR (resting metabolic rate)o & is more difficult to obtain]o TEF – thermic effect of foodo Activity thermogenesis –exercise & activity contributes ~60-75% of total daily energy expenditure• Harris-Benedict Equation- BMR 69%o Males = 66.5 + (13.75 x wt) + (5 x ht) - (6.8 x age)o Females = 655 + (9.6 x wt) + (1.8 x ht) – (4.7 x age)o Wt = kg, Ht = cm, age = years• Mifflin-St. Jeor - RMR 82%-*more accurateo Males = (10 x wt) + (6.25 x ht) – (5 x age) + 5o Females = (10 x wt) + (6.25 x ht) – (5 x age) – 161o Wt = kg, Ht = cm, age = years• Injury factors:o 1.2 – minor surgeryo 1.35 - skeletal traumao 1.44 – elective surgeryo 2.1-2.5 – severe thermal burns• Activity factors:o 1.2 – sedentary or wt. maintenanceo 1.55 – moderately active (3-5 days/wk)o 1.725 – very active• Weight changeo 3500 kcal = 1 lb.o So, to lose 1 lb in a week = 3500 kcal deficit /7days =500kcal deficit per day)• Decline in metabolic rate & energy expenditure with ageo ~2% decline per decade in adulthoodo Correspond w/ declines in physical activity & lean muscle massUnderstand and remember acceptable macronutrient distribution ranges• Protein: 10-35%• Fat: 20-35%• Carbohydrate: 45-65%Recommended dietary fiber for males and females• 38 g for men• 25 g for women• OR 14 g/1000 kcalELDERLY NUTRITION:Definitions:• 65-74yrs = “young old”• 75-84yrs = “aged”• 85 and up = “oldest old”Longevity depends on….• Longevity = length of life; it is a measure of life’s duration in years• 19% on genetics• 10% on access to high-quality health care• 20% on environmental factors (i.e. pollution)•